11-586 (7)Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
INSPECTION'S PHONE NUMBER: (305) 762.4949
BUILDING
PERMIT APPLICATION
FBC 20
Permit No.
Tggi_MMan
SEP 2 @ 2011
Master Permit No.
11 -546 6
Permit Type: BUILDING ROOFING
OWNER: Name (Fee Simple Titleholder): IAN ‘16-5441 Phone #: 3°5
Address: 11 'At 0 i4 7' - i', L
City: 1 Au■rt c osts
Tenant/Lessee Name: $ems i ,►Q.' I61� Phone #:
Email:
State:
Zip: 3 `3161
JOB ADDRESS: 1130o lJ 2.
City:
Folio/Parcel #•
Miami Shores
County:
Miami Dade
'a° ? OOD061k0
Is the Building Historically Designated: Yes NO
CONTRACTOR: Company Name:
Address: 16' 11-
4
Zip: bt
Flood Zone:
6000.\46 , w-c,
•1
Phone #: 91z9 - i t&i
City: L e.N.'$,4.,4 State:
,nom Aleear
Qualifier Name:
G 41\ L
Zip: 3TV�j 1
Phone #: So94
State Certification or Registration #: c (15 Db4t 7 Certificate of Competency #:
Contact Phone #: q54— 410 501/ Email Address: hO CO c'1
DESIGNER: Architect/Engineer: elrt.eWotn tASt...p
Phone #:
Value of Work for this Permit: $ Square/Linear Footage of Work:
Type of Work., ,.0 Addition ❑Alteration
Description of Work: 3c`e\ —c,..,
c�6 6'MtT
❑New ❑Repair/Replace
nkNo
'L�f ►��5
❑Demolition
* * * * * * * * * * * * * * * * * * * * * * * ** * * * * * * * * ** ***Fees * ** * * ** ,**, * * * * * * * * * *** * * * * * * * * * * * * * * *** **
Submittal Fee $ Permit Fee $ y. oA0 CCF $ CO /CC $
Scanning Fee $ Radon Fee $ DBPR $ Bond $
Notary $ Training/Education Fee $ Technology Fee $
Double Fee $ Structural Review $
TOTAL FEE NOW DUE $ 9' .00
Bonding Company's Name (if applicable)
Bonding Company's Address
City State Zip
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
City State Zip
Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has
commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating
construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS,
WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC
OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all
applicable laws regulating construction and zoning.
"WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR
IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN
FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE
RECORDING YOUR NOTICE OF COMMENCEMENT."
Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will not be appro nd a reinspection fee will be charged.
Signature
Owner or Agent
The foregoing instrument was acknowledged before me this /A
day of j am —, 20 i/ , by br g c0 j vA'V -e--aLS' ,
who is personally known to me or who has produced
As identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
My Commission Ex
The for Vim! •
day of
Contractor
trume was ackn
20 , by
who is personally known to me or who has prod ced°
as identification and who did take an oath.
NOT ' Y
Sign:
Print:
My Commis
UBLIC:
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: MyComEE128
•a Commission lions tar Assn
ri h
Tt°U9h
National V
********************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *, rye * * * ** * * * ****** ***** * *x *x *** **** * *** ** * * * * * * * **** ****
APPROVED BY
(Revised 07 /10 /07)(Revised 06 10 /2009)(Revised 3/15/09)
Plans Examiner
Zoning
Structural Review Clerk
CANNONDESIGN
SUBMITTAL IDENTIFICATION SHEET
To be completed by Contractor/CM
Project Name /Address /Number
Barry University Residence Hall
11300 NE 2nd Ave
Miami Shores, FL 33161
Cannon Design Project No. 03617.00
Owner
Barry University
Architect / Engineer
Cannon Design
Submitted By
TEM Systems
Contractor / CM Submittal No.
000220
Drawing / Detail Reference
L0905
Manufacturer / Supplier
TEM Systems
Priority:
❑ Critical
Cannon Design Submittal No.
Specification Section/ Paragraph
08 34 56 - Security Gates
Item / Product ID
Security Arm Gate S.D.
Required Date:
September 28, 2011
Remarks or Deviations
Contractor / CM Certification
(submittals not certified will be returned without review)
C. Amdall
To be completed by Reviewer
Cannon Dee tgn S bmilttal Number and Received Date
Received Can _S Sept. 21, 2011
Submittal=
€x.83456 -001
Cannon Design,
Requirements for Submission to Cannon Design
Shop Drawings:
Product Data:
Samples:
XA. No Exceptions Taken
No further review of submittal is required.
❑ B. Make Correction Noted
Incorporate corrections in work; resubmission is not required unless
otherwise noted.
❑ c. Revise and Resubmit
Revise as noted, and resubmit for further review.
❑ D. Rejected
Submittal not in compliance with Contract Documents.
❑ E. For Record Only
Received for record purposes only.
Review Is for conformance with the design concept of this project and for general compliance
with contract documents. Contractor Is responsible for quantities, dimensions and compliance
with contract documents and for information that pertains to fabrication processes, construction
techniques and coordination of this work with all trades which will be affected thereby. This
review is null and void ff submittal deviates from contract documents and does not Indicate or
note deviations.
AIE Comments
September 21, 2011 P. Mendola 09.26.11
Reviewed by
Date
Reviewed by
Date
08/08
MC)SS
Moss & Associates, LLC
2101 N Andrews Avenue 300
Ft Lauderdale FL 33311
TRANSMITTAL
No, 000102
PROJECT: Barry University Residence Hall
TO: Cannon Design
2170 Whitehaven Road
Grand Island NY 14072
ATTN: Peter Mendola
DATE: 09/21/2011
RE: Security Arm Gate Shop Drawing
JOB: 2010023
WE ARE SENDING:
SUBMITTED FOR:
i/ Approval
ACTION TAKEN:
n Approved as Submitted
17 Shop Drawings
Letter
Your Use
Approved as Noted
fl Prints
As Requested
n Returned After Loan
fl Change Order
Review and Comment
fl Resubmit
Plans
Submit
7 Samples
SENT VIA:
riAttached IlSeparate Cover
^ Retumed
I I Retumed for Corrections
I I Specifications
fl Other.
WI Due Date: 09/20/2011
n Other:
Line Item
Package Code
Rev. Qty Date Description
Status
1 Submittal
REMARKS:
CC: Cannon Design, NikoII Johnson
000220 1 1 09/21/2011 Security Arm Gate Shop Drawing Reviewed by GC
Signed:
Charlie Amdall
CONSTRUCTION MANAGER
MOSS & ASSOCIATES, LLC
Barry University Residence Hall — Job No. 2010023
Submittal No. 000220
X
Reviewed
Reviewed as Noted
Reviewed as Noted — Resubmit
Not Approved — Resubmit
Review of this submittal is for general conformance with contract requirements.
SubeontractorNendor is responsible for dimensions, quantities, & coordination with
other trades. Approval does not relieve SubcontractorNendor of his responsibilities to
fully comply with the contract documents.
By: C. Arndall
Date: 9/21/11
September 23, 2011
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